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[A new procedure for prevention of MNMS using a plasma filter]
1Second Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
Abstract:
In order to prevent myonephropathic metabolic syndrome (MNMS) following acute arterial occlusion of the extremities, the efficacy of plasma filtration to eliminate myoglobin which causes acute renal failure and other metabolites was evaluated by experimental model. Twenty five mongrel dogs weighing 10 to 20 kg were used. Infra-renal aorta and unilateral femoral arteries were ligated and 2/3 of the femoral muscle was carved. After 24 hrs, these ligations were released and thrombectomy was carried out. The dogs were divided into two groups: Group 1 was consisted of the dogs without any treatment and group 2 dogs were treated by plasma filtration. The changes in serum myoglobin, potassium, lactic acid and etc. were compared between the two groups. The plasma filter was hollow-fiber type that was made of polypropylene fiber. The serum level of myoglobin, potassium, CPK, GOT and BUN tended to decrease remarkably after revascularization in group 2 in contrast with those in group 1. There were statistically significant differences between the corresponding data of the two groups. Although the lactic acid levels were lower in group 2 than group 1, those were not significant statistically. In conclusion, the application of plasma filter was effective for the treatment of hyperkalemia and removal of myoglobin and unknown moderate molecular weight pathogenic substances to prevent MNMS.
Insights
Plasma filtration effectively removes myoglobin and reduces hyperkalemia following limb ischemia. This treatment helps prevent myonephropathic metabolic syndrome (MNMS) by clearing harmful substances after revascularization.
Area of Science:
- Nephrology
- Experimental Surgery
- Toxicology
Context:
- Acute arterial occlusion of the extremities can lead to myonephropathic metabolic syndrome (MNMS).
- Myoglobin release from damaged muscle is a primary cause of acute renal failure in these cases.
- Standard treatments may not adequately clear all harmful metabolites contributing to MNMS.
Purpose:
- To evaluate the efficacy of plasma filtration in preventing MNMS after acute limb ischemia.
- To assess the removal of myoglobin and other metabolites using plasma filtration in an experimental model.
- To compare outcomes between dogs treated with plasma filtration and an untreated control group.
Summary:
- An experimental model using dogs with acute arterial occlusion demonstrated the effectiveness of plasma filtration.
- Plasma filtration significantly reduced serum levels of myoglobin, potassium, CPK, GOT, and BUN post-revascularization compared to controls.
- The study concluded that plasma filtration is effective in treating hyperkalemia and removing pathogenic substances to prevent MNMS.
Impact:
- Plasma filtration shows promise as a therapeutic strategy to mitigate kidney damage following limb ischemia.
- This approach may prevent severe complications like MNMS by actively clearing toxins from the bloodstream.
- Findings support the clinical application of plasma filtration in managing patients at risk for acute renal failure due to muscle injury.
